The Long-term Effects of Immersive Virtual Reality Reminiscence in People With Dementia: Longitudinal Observational Study

Abstract

Background: Novel nonpharmacological therapies are being developed to prevent cognitive decline and reduce behavioral and psychological symptoms in patients with dementia. Virtual reality (VR) reminiscence was reported to improve anxiety, apathy, and cognitive function immediately after intervention in individuals at residential aged care facilities. However, its effect on elderly patients with dementia and how long this effect could last remain unknown.

Objective: The aim of this paper is to investigate the effect of immersive VR reminiscence in people with dementia both immediately after and 3-6 months after intervention.

Methods: A pilot study was conducted in 2 dementia care units. VR reminiscence therapy sessions were conducted twice per week for a 3-month period. Cognitive function, global status, depressive symptoms, and caregiver burden were assessed before and immediately after VR intervention in 20 participants. Subsequently, 7 participants were reassessed 3-6 months after the VR intervention. Wilcoxon sign-rank test was used for statistical comparisons of the changes.

Results: There were no significant changes in cognitive function, global status, and caregiver burden immediately after the VR intervention, but there was a significant reduction in depressive symptoms (P=.008). Moreover, compared with the cognitive function immediately after VR, it kept declining 3-6 months after.

Conclusions: Immersive VR reminiscence can improve mood and preserve cognitive function in elderly patients with dementia during the period of the intervention. Studies using a control group and comparing the use of VR with traditional forms of reminiscence should be conducted in the future to confirm and expand on these findings.

Keywords: dementia; long-term care; reminiscence; virtual reality.

Figure 1

Scenes from the computer generated virtual reality reminiscence. Computer graphics images based on (A) a historical type of residence that was commonly found throughout Taiwan between 1960-1980 AD. (B) The participants could use the controllers to turn on the radio to play music and (C) to open the photo album to browse the photographs with a voice narrating. (D) They could also use the controllers to hold rice to feed chickens, which was traditional in older villages.

Figure 2

Mini-Mental State Examination (MMSE) and Cognitive Abilities Screening Instrument (CASI) scores before, immediately after, and 3-6 months after virtual reality (VR) reminiscence in 7 participants. Data are shown as mean (SD) for quantitative variables. A comparison of a) MMSE and b) CASI scores before and immediately after VR as well as immediately after VR and 3-6 months after VR were evaluated by Wilcoxon sign-rank test (P<.05 is statistically significant); i: immediately.